Diagnosis and surgical treatment of ectopic atrial tachycardia

• Published in: European journal of cardio-thoracic surgery Vol. 5; no. 4; pp. 199 - 204
• Main Authors: BREDIKIS, J, LEKAS, R, BENETIS, R, SILEIKIS, V, VEIKUTIS, V, KRISCIUKAITIS, A, VASKELYTE, J
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier Science B.V 01.01.1991; Elsevier Science
• Subjects: Adolescent; Adult; Atrioventricular Node - physiopathology; Atrioventricular Node - surgery; Biological and medical sciences; Bundle of His - physiopathology; Bundle of His - surgery; Cardiac dysrhythmias; Cardiac Output - physiology; Cardiac Pacing, Artificial; Cardiology. Vascular system; Child; Child, Preschool; Cryosurgery - instrumentation; Electrocardiography - instrumentation; Electrodes; Female; Heart; Heart Rate - physiology; Humans; Infant; Male; Medical sciences; Middle Aged; Pacemaker, Artificial; Tachycardia, Ectopic Atrial - diagnosis; Tachycardia, Ectopic Atrial - physiopathology; Tachycardia, Ectopic Atrial - surgery; Vectorcardiography - instrumentation; Heart; Human; Treatment; Arrhythmia; Surgery; Cardiovascular disease; Diagnosis; Paroxysmal atrial tachycardia; Excitability disorder
• ISSN: 1010-7940; 1873-734X
• DOI: 10.1016/1010-7940(91)90030-N

Eighty-two patients with ectopic atrial tachycardia (EAT) were subjectedto radical closed heart surgery (without cardiopulmonary bypass). The ageof the patients ranged from 1 to 51 years. Permanent EAT was present in 19patients, incessant EAT in 14, and paroxysmal EAT in 49 patients.Preoperative electrophysiological study included computed analysis of the Pwave vector. Ectopic foci were established in the right atrium in 34patients, in the left atrium in 11, in the interatrial septum in 32, andextracardially in 5 patients. For ablation or isolation of the foci, thecryogenic technique was used in 74 patients, cryo- and laser techniques in4, and the laser technique alone in 1 patient. In 3 patients resection ofthe atrial auricles including the ectopic focus was undertaken. In 4patients complete AV block was induced and a cardiac pacemaker implanted.After primary surgery, favourable results were obtained in 71 patients. In11 patients recurrences were observed; 8 of these patients underwentsuccessful repeat surgery. In 3 patients medical treatment was effective.Finally, the follow-up results have been promising-79 patients (96.4%)(including 4 patients in whom a complete AV block was created) have becomearrhythmia-free. When EAT is resistant to medical treatment, closed heartablation of the ectopic focus has proved to be safe (no mortality ormorbidity) and effective. It can therefore be recommended not only for thetermination of EAT but also for the prevention of dilatedcardiomyopathy.